Download Poster (261 KB)


The majority of school-based occupational therapy (OT) referrals are for handwriting. In fact, fine motor and handwriting concerns affecting educational performance make up 80-85% of OT referrals in schools. Occupational therapists use an abundance of interventions for remediating handwriting difficulties, but there is scant evidence of why specific strategies or combinations of strategies are effective.

Cognitive interventions have shown to be successful in the treatment of handwriting. Metacognitive skill, a component of cognition, allows a child to self-monitor and self-reflect on his or her handwriting skills to correct mistakes and generate goals for improvement. Therefore, a child’s ability to self-reflect on handwriting is likely an important factor when strengthening the learning and use of handwriting. Having insight into a child’s reflection of his or her handwriting abilities will also assist occupational therapists in creating an appropriate and effective handwriting intervention. This study aims to contribute to the evidence regarding the development and treatment of handwriting skill in elementary school-aged children.


Occupational Therapy

Faculty Advisor

Melisa Kaye, MS, OTR/L

Publication Date

Fall 2015


Sacramento, CA


Occupational Therapy

Handwriting and Metacognition: The Relationship Between Self-Reflection and Penmanship